This intervention combines a theory-based sexual risk reduction intervention
with a group-based alcohol risk reduction motivational enhancement therapy. The
aim is to reduce risky sexual behavior and sexual behavior while under the
influence of alcohol among criminally involved adolescents. Positive impacts
were found for risky sexual behavior at the three-month follow-up and for
attitudes toward condom use, perceived condom use norms, intentions to practice
safer sexual behavior, and self-efficacy at post-test. Impacts were not found
for sexual behavior while under the influence of alcohol at the three-month
follow-up.

DESCRIPTION OF PROGRAM

Target population:
Criminally involved adolescents

This program involves a single three to four-hour session conducted in same-sex
groups of one to ten adolescents. Intervention leaders are the same gender as
the participants and follow a scripted intervention manual. The group
psychosocial intervention (GPI) component uses group activities, videos, condom
use demonstrations, group discussion, and goal setting. Information is given on
HIV and health services, and there is a focus on developing normative
perceptions and positive attitudes toward condoms and self-efficacy. In the
group motivational enhancement therapy (GMET) component of the intervention,
participants are given feedback on their alcohol use behavior, based on their
pre-test responses. This feedback is then used to facilitate a group discussion
that focuses on changing alcohol use behavior in the context of sexual activity.
It includes discussion of alcohol use and behavior and strategies for developing
self-efficacy and reducing alcohol use risk.

EVALUATION OF PROGRAM

Evaluated population:
484 adolescents residing in three detention facilities in Denver, Colorado. The
age range was 14 to 17 years, and the average age of participants was 16 years.
The sample was 83 percent male, 37 percent white, 29 percent Hispanic, 13
percent African American, 5 percent Native American, 4 percent Asian, 2 percent
other, and 13 percent biracial.

Approach:
Following adolescent assent and parent/guardian consent, adolescents were
scheduled for the next available intervention session. Each session was randomly
assigned to one of three groups: GPI, GPI + GMET, or a control information only
condition. The control condition lasted approximately two hours and involved
providing participants with basic information on STDs and a question and answer
session. For more information on GPI click here. Participants were assessed on attitudes toward condom use, perceived
condom use norms, intention to practice safer sex, and self-efficacy at baseline
and immediately following the intervention and were assessed on risky sexual
behavior and sexual behavior while under the influence of alcohol at baseline
and the three-month follow-up.

Results:
Adolescents who received the GPI + GMET intervention had more positive attitudes
toward condom use, perceived condom use norms, and intentions to practice safer
sex at post-test when compared with the control information-only intervention.
Adolescents who received the GPI + GMET intervention also had higher
self-efficacy at post-test and engaged in less risky sexual behavior at the
three-month follow-up, compared with those who received the control
information-only intervention. There was no impact of the treatment on sexual
behavior while under the influence of alcohol.

The GPI + GMET was also found to be more effective than GPI alone on attitudes,
perceived norms, and intentions.